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1447017082
AUGUST BRUCE WAGNER
PORTLAND, OR
NPI
1447017082
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OR R8260)
Enumeration Date
2024-02-29
Last Update Date
2024-02-29
Business Address
AUGUST BRUCE WAGNER
333 SW TAYLOR ST STE 200
PORTLAND, OR 97204-2446
Phone number: 503-446-2500
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Mailing Address
AUGUST BRUCE WAGNER
17570 NW CORNELL RD APT 7
BEAVERTON, OR 97006-8641
Phone number: 970-567-5203
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